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result(s) for
"Brouzas, Dimitrios"
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Large Retinectomies for Retinal Detachment Complicated by Proliferative Vitreoretinopathy: Anatomical and Functional Outcome of Silicone Oil versus Perfluoropropane Gas
by
Moschos, Marilita M
,
Droutsas, Konstantinos
,
Dettoraki, Maria
in
Diabetic retinopathy
,
large retinectomies
,
Membranes
2020
To assess the anatomic and functional outcomes of eyes undergoing vitrectomy and large retinectomy for the management of retinal detachment (RD) complicated by advanced proliferative vitreoretinopathy (PVR).
A total of 66 eyes of 63 patients with RD complicated by PVR were treated with vitrectomy and 180° or more retinectomy and silicone oil (n=46) or perfluoropropane gas (n=20) were used as intraocular tamponades.
Retinal reattachment was achieved in 89.39% (59 eyes) of the cases. The mean follow-up was 33.7 months (range 12-76 months). In gas-filled eyes, the final anatomic success rate was 85% (17 eyes) and in silicone oil-filled eyes was 91.3% (42 eyes) (p=0.46). After the initial retinectomy, the total anatomic success rate was 80.3% (53/66 eyes), 70% in gas-filled eyes (14/20 eyes) and 84.79% in silicone oil-filled eyes (39/46 eyes) (p=0.19). Visual acuity (VA) improved in 37 (56.06%) eyes, remained the same in 19 (28.78%) eyes and became worse in 10 (15.15%) cases. Best corrected VA was ≥20/200 in 22 eyes 33.33%. The final VA was associated with the preoperative VA (r=0.68), the preoperative status of the macula influence significantly the final visual acuity (p<0.0001) and there is statistically significant difference in the final visual acuity between eyes with and without anatomic success (p<0.05).
The large circumferential retinectomies can be beneficial in eyes with RD complicated by advanced PVR. No significant difference was found in anatomic success rate, and rate of complications between eyes with silicone oil tamponade and long acting gas undergoing large retinectomy. Regarding the final BCVA, slight difference was found in favor of gas-filled eyes.
Journal Article
Optical Coherence Tomography Angiography Changes in Patients Diagnosed With Acute Coronary Syndrome: A Systematic Review and Meta-Analysis
by
Giannopoulos, Georgios
,
Mitsopoulou, Dimitra
,
Katsimpris, Andreas
in
Acute coronary syndromes
,
Angina pectoris
,
Bias
2024
We conducted a systematic review and meta-analysis to assess the association between optical coherence tomography angiography (OCTA) parameters and acute coronary syndrome (ACS). Two independent reviewers searched the electronic databases (MEDLINE (Medical Literature Analysis and Retrieval System Online), Scopus, Embase (Excerpta Medica Database), Cochrane Library, ClinicalTrials.gov, and World Health Organization International Clinical Trials Registry Platform) from inception until April 2023. According to the inclusion criteria of this review, eligible were observational studies, randomized control trials, and registry/database studies that included the eyes of adult ACS patients and assessed OCTA parameters within the macula. The pooled standardized mean differences (SMD) between patients diagnosed with ACS and healthy controls with a confidence interval (CI) of 95% were calculated using the Hartung-Knapp-Sidik-Jonkman random-effects method. The heterogeneity was assessed by I
and the Cochran Q and a random effects model was applied. Seven studies were eligible and included in our systematic review (n = 898), of which three were included in the meta-analysis (n = 341). The pooled SMD in the superficial vascular plexus (SVP), deep vascular plexus (DVP), and foveal avascular zone (FAZ) were -0.46 (95% CI: -0.94 to 0.01, p = 0.05, I
= 0%, three studies), -0.10 (95% CI: -3.20 to 3.00, p = 0.75, I
= 67%, two studies), and 0.43 (95% CI: -1.22 to 2.09, p = 0.38, I
= 92%, three studies), respectively. Our findings suggest that there are no differences in OCTA metrics between ACS patients and healthy individuals.
Journal Article
Optical Coherence Tomography Evolution in a Case of X-Linked Juvenile Retinoschisis: 15 Years of Follow-Up
by
Theodossiadis, Panagiotis
,
Brouzas, Dimitrios
,
Theodossiadis, George
in
Case Report
,
Case reports
,
Children’s vision
2017
Purpose: We present the evolution of X-linked juvenile retinoschisis (XLRS) in a male patient using optical coherence tomography (OCT) with a long-term follow-up time of 15 years. Case Description: A 10-year-old male patient presented at the Medical Retina Department of our hospital complaining for blurred vision in both eyes. At the initial presentation in 2001, his best corrected visual acuity (BCVA) was 6/12 in both eyes on the Snellen chart. Based on clinical and OCT findings, the diagnosis of XLRS was made, and it was confirmed by genetic testing. No treatment was performed, but the patient was regularly examined. His BCVA and OCT findings remained relatively stable from 2001 to 2012, when BCVA decreased to 6/18 and 6/24 in the right and left eye, respectively. In 2016, his BCVA was 6/24 and 6/36 in right and left eye, respectively, while OCT depicted significant macular thinning, accompanied by irregularities of the foveal contour in both eyes. Conclusion: Patients with XLRS should be monitored regularly to evaluate the progression of the disease and manage the potential complications.
Journal Article
Trapped Pre-Macular Bubble of Octafluoropropane Gas Masquerading as Retained Submacular Perfluorocarbon Liquid
by
Banerjee, Philip J.
,
Kokosiouli, Despoina-Georgia
,
Patel, Trushar
in
Case Report
,
Case reports
,
Gases
2019
Introduction: To demonstrate, with the aid of retinal imaging, an abnormal post-operative macular appearance caused by the presence of a “fragmented” pre-retinal bubble of octafluoropropane (C 3 F 8 ) masquerading as retained subretinal perfluorocarbon liquid (PFCL). Methods: This is an interventional case presentation. Results: Colour fundus photography high-resolution spectral domain-optical coherence tomography (SD-OCT) and clinical progress demonstrate that the abnormal reflex was caused by the presence of a small fragment of C 3 F 8 becoming lodged at the pre-foveal area. Conclusion: Submacular entrapment of various substances used during vitrectomy has been described in a number of case reports and case series. To our knowledge, this is the first described case of a retained fragment of fluorocarbon gas trapped at the macula following successful retinal detachment repair and highlights a previously unreported cause of an abnormal foveal appearance. However, clinical examination together with the use of SD-OCT is helpful in differentiating the appearance from that seen in other retained vitrectomy adjuncts.
Journal Article
Pseudotumor Cerebri in a Child with Idiopathic Growth Hormone Insufficiency Two Months after Initiation of Recombinant Human Growth Hormone Treatment
by
Demosthenous, Constantinos
,
Brouzas, Dimitrios
,
Loukianou, Eleni
in
Care and treatment
,
Case Report
,
Case studies
2016
Purpose. To report a rare case of pseudotumor cerebri (PTC) in a child two months after receiving treatment with recombinant human growth hormone (rhGH) and to emphasize the need of close collaboration between ophthalmologists and pediatric endocrinologists in monitoring children receiving rhGH. Methods. A 12-year-old boy with congenital hypothyroidism started treatment with rhGH on a dose of 1,5 mg/daily IM (4.5 IU daily). Eight weeks later, he was complaining of severe headache without any other accompanying symptoms. The child was further investigated with computed tomography scan and lumbar puncture. Results. Computed tomography scan showed normal ventricular size and lumbar puncture revealed an elevated opening pressure of 360 mm H2O. RhGH was discontinued and acetazolamide 250 mg per os twice daily was initiated. Eight weeks later, the papilledema was resolved. Conclusions. There appears to be a causal relationship between the initiation of treatment with rhGH and the development of PTC. All children receiving rhGH should have a complete ophthalmological examination if they report headache or visual disturbances shortly after the treatment. Discontinuation of rhGH and initiation of treatment with acetazolamide may be needed and regular follow-up examinations by an ophthalmologist should be recommended.
Journal Article
Sustained ocular hypertension following intravitreal injections of 0.5 mg/0.05 ml ranibizumab
by
Loukianou, Eleni
,
Apostolopoulos, Michael
,
Brouzas, Dimitrios
in
Aged
,
Aged, 80 and over
,
Antibodies, Monoclonal, Humanized - administration & dosage
2011
To report three cases with sustained ocular hypertension following intravitreal injections of 0.5 mg/0.05 ml ranibizumab and to underline the importance of monitoring intraocular pressure (IOP) following intravitreal injections of ranibizumab (Lucentis). Three patients were found to have high IOP after intravitreal injections of 0.5 mg/0.05 ml ranibizumab. IOP was elevated after the second ranibizumab injection in patients 1 and 2, and after the third injection in patient 3. The increase in IOP was sustained, requiring treatment with anti-glaucoma eye drops in all patients, the addition of systemic carbonic anhydrase inhibitor in one patient, and the application of selective laser trabeculoplasty (SLT) in another patient. None of the patients had a previous history of glaucoma or ocular hypertension. Sustained ocular hypertension may occur after intravitreal injections of 0.5 mg/0.05 ml ranibizumab. Although the precise mechanism of the pressure rise is unknown, three eyes in our series were controlled with topical or oral medication and one with SLT. The necessity of IOP monitoring is strongly emphasized after intravitreal injections of 0.5 mg/0.05 ml ranibizumab.
Journal Article
Massive choroidal hemorrhage after intravitreal administration of bevacizumab (Avastin®) for AMD followed by controlateral sympathetic ophthalmia
2009
To report a severe ocular complication initiated ten days after intravitreal administration of bevacizumab (Avastin((R))), in a patient with exudative age-related macular degeneration (AMD).
Case report.
Ten days after intravitreal injection of 1.25 mg Avastin((R)), the patient manifested acute loss of vision with excruciating pain. An extensive choroidal detachment was evident in close contact with the lens, which necessitated an emergency sclerotomy with reconstruction of the anterior chamber. Four months later, the eye proceeded to phthisis bulbi. Five months after the injection, the patient complained of mild pain, photophobia, and visual acuity deterioration from the fellow eye. The diagnosis of sympathetic ophthalmia was suggested and treated with intravitreal injections of triamcinolone acetonide every three months with good response, complicated by elevation of intraocular pressure which we managed with Ahmet valve implantation.
Serious ocular complications after intravitreal of Avastin((R)) can not be excluded, including massive choroidal hemorrhage and sympathetic ophthalmia of the fellow eye.
Journal Article
Bevacizumab (Avastin®) for the management of anterior chamber neovascularization and neovascular glaucoma
2009
To establish the efficacy and safety of intravitreal bevacizumab in reducing iris and anterior chamber angle neovascularization and managing neovascular glaucoma.
Prospective interventional case series.
Eleven eyes of 11 patients with iris and anterior chamber angle neovascularization with refractory intraocular pressure were treated with intravitreal injection of 1.25 mg bevacizumab (Avastin((R))). The study group included eight males and three females aged 23 to 77 years (average, 62 years). Out of the 11 cases, five had proliferative diabetic retinopathy, of whom two had undergone vitrectomy for tractional retinal detachment and vitreous hemorrhage, and six were secondary to ischemic central retinal vein occlusion (CRVO). All patients were followed for eight to 16 months (average, 10 months).
Iris and anterior chamber angle neovascularization receded in all eyes after one to three injections at monthly intervals. In five eyes, neovascularization recurred during the follow-up period. The intraocular pressure normalized in one eye. Four eyes were controlled with anti-glaucoma drops. A cyclodestructive procedure was required in two eyes. An Ahmet drainage valve was implanted in four eyes, including one controlled with additional antiglaucoma drops and one in which the intraocular pressure remained high while on maximum antiglaucoma medication and a cyclodestructive procedure was scheduled.
Bevacizumab appears to be effective in reducing iris and anterior chamber angle neovascularization and is likely to extend our therapeutic options in the management of neovascular glaucoma.
Journal Article
Visual field examination method using virtual reality glasses compared with the Humphrey perimeter
by
Papaconstantinou, Dimitrios
,
Moschos, Marilita M
,
Droutsas, Konstantinos
in
Automation
,
Calibration
,
Care and treatment
2017
To present a visual field examination method using virtual reality glasses and evaluate the reliability of the method by comparing the results with those of the Humphrey perimeter.
Virtual reality glasses, a smartphone with a 6 inch display, and software that implements a fast-threshold 3 dB step staircase algorithm for the central 24° of visual field (52 points) were used to test 20 eyes of 10 patients, who were tested in a random and consecutive order as they appeared in our glaucoma department. The results were compared with those obtained from the same patients using the Humphrey perimeter.
High correlation coefficient (
=0.808,
<0.0001) was found between the virtual reality visual field test and the Humphrey perimeter visual field.
Visual field examination results using virtual reality glasses have a high correlation with the Humphrey perimeter allowing the method to be suitable for probable clinical use.
Journal Article
Nonarteritic anterior ischemic optic neuropathy associated with chronic anemia: a case series of myelodysplastic syndrome patients
2009
We report on three cases of visual loss due to nonarteritic anterior ischemic optic neuropathy that developed during the course of refractory anemia, a subtype of myelodysplastic syndrome.
Patients underwent fundus, visual field examination, and fluorescein angiography. A thrombophilic tendency investigation including prothrombin time, partial thromboplastin time, protein C, free protein S, and antithrombin III, polymerase chain reaction and hybridisation to allele-specific oligonucleotide probes and a bone marrow biopsy were also performed.
Relative recovery of visual function was noted in two patients, a 58-year-old man and a 67-year-old woman, whereas the vision of the third patient, a 62-year-old man, showed only marginal improvement during the follow-up period. Two patients received vigorous blood transfusion during hospitalization, while dosage adjustment of the erythropoietin infusion was decided for the third one. Thrombophilic tendency was not identified in any patient.
Chronic anemia, as presented in myelodysplastic syndrome's refractory anemia subtype, probably in the presence of additional factors, such as hypotension, is likely to be complicated by optic neuropathy, possibly through a mechanism of anemic hypoxia and/or microvascular insufficiency.
Journal Article